Healthcare Provider Details

I. General information

NPI: 1528794740
Provider Name (Legal Business Name): KRYSTINA ALEXIS DOWNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 MARTIN F GIBBONS BLVD
DICKSON CITY PA
18519-1787
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-9800
US

V. Phone/Fax

Practice location:
  • Phone: 570-846-2340
  • Fax: 570-846-2341
Mailing address:
  • Phone: 570-846-2340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA063736
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: